Daawooyinka bayoolojiga ah , kuwaas oo lagu iibiyey noocyo kala duwan oo xanuunka nooca " inflammatory arthritis" laga soo bilaabo 1998, ayaa lagu maamulaa ama la isku duro . Dhibaatooyinka ka yimaada, oo laga yaabo inay ku dhacaan daawooyinkan, waxaa loogu yeeraa falcelin faleedka ama fal-celinta goobta tallaalka. Miyuu cabaadaa, miyaanay ahayn? Laakiin, waa inaad ogaataa in fal-celinta ay aad u xun yihiin oo badanaaba ay dhaafaan iyada oo aan wax fara-gelin ah.
Saameynta Nidaamyada Cadaadiska Lahaa
Dhibaatooyinka caadiga ah ee la xidhiidha dareen-celinta faafa waxaa ka mid noqon kara madax-xanuun, lalabo, irbadaha, cuncunka, finanka, daadinta, qandho, qarqaryo, qalab-dhagxaan (garaacid degdeg ah), iyo neefsasho adag (neefsashada oo dhibta).
In kastoo ay dhif tahay, fal-celin daran ama fal-celinta anaphylactic ayaa dhici karta. Xaaladahan oo kale, xakameynta laabta, bronchospasm, hypotension (cadaadiska dhiiga ee hooseeya), diaphoresis (dhidid), ama anaphylaxis (falcelin xasaasiyad daran ee borotiinka shisheeye oo ka dhasha soo-gaadhis hore). Haddii falcelin ba'an ay soo baxdo, daaweynta bayoolajiga waa in la joojiyaa isla markiiba iyo daryeelka degdegga ah ee la bixiyo. Xaaladaha qaarkood, daawada horay loo daaweeyo acetaminophen, antihistamine, iyo corticosteroid gaaban ayaa laga yaabaa in ay ka caawiso ka hortagga faleebo faleedka.
Sida laga soo xigtay qorayaasha Rheumatoid Arthritis: Early Diagnosis and Treatment , xogta baaritaanka kiliiniga ayaa shaaca ka qaaday in boqolkiiba 20% bukaannada la daweeyay Remicade (infliximab) ay yeesheen jawaab celin faleed ah, in ka yar 1% bukaannada Qaadista ah ee la daaweeyay waxay la kulmeen falcelin faleed-daran iyo kaliya 2.5% oo ka mid ah falcelinta faleebo ah ee ka midka ah bukaannada Qaadista Qaadista daaweynta ayaa keentay joojinta daroogada.
Caadi ahaan, falcelinta faleebo la xiriira Remicade ayaa dhacaya inta lagu gudajiro ama laba saacadood gudahood ka dib marka faleebada la dhammeeyo.
Aan ka fekerno wixii macluumaad ah oo ku saabsan daawooyinka nafleyda kale ee la soo bandhigay, in maskaxda lagu hayo in tijaabooyinka kala duwan ee kiliinikada aan la barbardhigi karin (tusaale ahaan, natiijooyinka tijaabinta dib u dhaca lama barbar dhigi karo natiijooyinka maxkamadaynta Simponi) iyo xogta tijaabinta kiliinikada looma kulmi karo dhaqanka.
- Simponi Aria: Wareegga kantaroolka ah ee Maxkamadeynta 1aad (ilaa todobaadkii 24), 1.1% oo ah faafidda Simponi Aria ayaa lala xiriiriyay falcelin galmo marka la barbardhigo 0,2% ee fedraalka ee kooxda xakamaynta. Rashku wuxuu ahaa dareen-celinta ugu badan ee faleebo. Diidmo fara badan lama soo sheegin.
- Orencia (abatacept): baadhitaanka orencia III, IV, iyo V ayaa shaaca ka qaaday in fal-celinta faafa ee ba'an ay ka badan yihiin bukaanka Orencia-daweeyey bukaanka marka la barbar dhigo placebo (9% iyo 6% siday u kala horreeyaan). Munaasabadaha badanaa la soo sheegey waxay ahaayeen madax-wareer, madax-xanuun, iyo dhiig-karka (1-2%). In ka yar 1% oo ka mid ah dadka Orencia-daweynta bukaanada la joojiyey isticmaalka daroogada sababtoo ah falcelinta faleebo ba'an. Anaphylaxis ayaa ka dhacday in ka yar 0.1% bukaannada la daweeyay Orencia.
- Actemra (qallajis): Daraasad kiliinig ah oo 24-toddobaad ah ayaa lagu sameeyay, falcelin faleedka oo degdeg ah ayaa dhacay 7-8% bukaanada, taas oo ku xidhan labadii qeybood ee loo yaqaan 'Actemra', marka la barbardhigo 5% kooxda xuubka loo yaqaan 'placebo'. Dhacdadii ugu badneyd intii lagu gudajirey faleebo waxay ahayd hypertension (1%). Dhacdooyinka ugu badan soo noqnoqda muddo 24 saacadood gudahood ah oo sambabada ah ayaa madax xanuun ah (1%) iyo falcelin maqaarka (1%). Munaasabadaha ma aysan keenin joojin ama xadidid daaweyn.
- Rituxan (rituximab): Maamulka Rituxan wuxuu keeni karaa mid halis ah, oo ay ku jiraan falcelinta faleebo dhimasho. Dhimashada 24 saac gudahood oo ka soo wareegtay Rituxan ayaa dhacay. Qiyaastii boqolkiiba 80% falcelinta faleebo dhimasho ayaa ka dhacay jimbireedkii hore.
Rituxan RA waxay soo ururisay daraasado lagu xakameynayo xayawaanka, xummad, qarqaryo, qallayl, pruritus, urtikaria ama finan, anjioedema, hindhiso, cuncun cunid, qufac, ama buro-bareebospasm, oo leh ama aan lahayn isku-buuq-celin ama dhiig-karka) waxay la kulmeen 27 Boqolkiiba% bukaanada Rituxan-daweeyey ka dib markii ay faleebo ugu horeysay, marka la barbardhigo 19% kooxda xuubka ah. Xaaladda dhacdooyinka faleebo ba'an ee soo noqnoqda kadib markii faleebo labaad ee Rituxan ama placebo ayaa hoos u dhacday 9% iyo 11%, siday u kala horreeyaan. Dareen-celinta faleebo ba'an ayaa waxaa soo maray qiyaastii <1% bukaannada ku jira kooxda daaweynta.
Beddelaadda qiyaasta ayaa loo baahan yahay 10% oo ka mid ah bukaannada Rituxan-la daweeyay iyo 2% kooxda xudunta.
Saameynta Ciladda ee Ciladda
Daawooyinka bayoolojiga ah ee lagu maamulo subcutaneously, dareen-celinta goobta ayaa dhici karta laakiin sida caadiga ah ma jirto daaweyn loo baahan yahay iyo joojinta daroogada ma aha lagama maarmaan.
Cilmi-baadhayaashu waxay sidoo kale eegeen xogta bukaan-eegtada si ay u qiimeeyaan inta jeer ee daaweynta cirbadeynta. Inkastoo ay bixiso fikrad qaar, xasuuso, tijaabooyinka kaladuwan ee kala duwan looma barbar dhigi karo iyo xogta tijaabada ee kiliinikada ma aha mid muujinaysa waxa ka dhacaya dhaqdhaqaaq dhab ah.
- Calaamadaha lagu magacaabo 'Enbrel' ('etanercept'): Marka lagu jiro tijaabooyinka xakameynta xakamaynta xeeladaha rheumatoloji, qiyaastii 37% bukaannada lagu daweeyo Enbrel waxay sameeyeen dareen-celin goobeed. Dhamaan fal-celinta goobta cirridka ayaa lagu qeexay mid fudud (dhexdhexaad, cuncun, xanuun, barar, dhiig-bax, nabar) oo guud ahaan ma keento joojinta daroogada. Diidmada jawaab celinta goobta, inta badan waxay socotaa 3 illaa 5 maalmood, guud ahaan waxay ku dhacdaa bisha ugu horreysa kadibna waxay hoos u dhacdey marxaladda.
- Humira (Adalimumab): Dhakhaatiirta la xakameynayo ee loo yaqaan 'placemo-control', 20% bukaanada lagu daaweeyo Humira waxay sameeyeen dareen-celin goobeed (durbadi, cuncun, dhiig xanuun, barar ama barar), marka la barbardhigo 14% bukaanka qaata placebo. Inta badan fal-celinta goobta cirridka ayaa lagu qeexay mid fudud oo guud ahaanna lagama maarmaan u ah joojinta daroogada.
- Simponi (golimumab): Marka la eego tijaabooyinka wajiga labaad ee II / III, 3.4% dadka bukaanka ah ee Simponi qabay ayaa leh jawaab celin goobta daawada ah marka la barbardhigo 1.5% kooxda kantaroolka. Inta badan jawaab-celinta goobta cirridka ayaa ah mid sahlan oo dhexdhexaad ah, oo leh astaamaha soo noqnoqonaya ladnaantu.
- Cimzia (certolizumab pegol): Waxaa jiray xusid mudnaanta jawaab celinta goobta cimzia ee ku jirta macluumaadka qoraalka ah, oo lagu tilmaamay mid naadir ah, laakiin faahfaahin faahfaahsan lama bixin.
Ilaha:
Rheumatoid Arthritis: Daaweynta Hore iyo Ciladda. Cush, Weinblatt, Kavanaugh. 2010. Wargeyska Saddexaad. Xiriirka Xirfadaha, Inc.